Eosinophilic Esophagitis Clinic Visits
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Typically, the Eosinophilic Esophagitis (EoE) clinic visit involves 3 days (Monday, Wednesday, and Thursday).
On Monday, after speaking with your Gastroenterologist, the Allergist will ask you several questions about what type of symptoms your child has with particular foods and then perform a physical exam. To find out if your child has any food allergies, he or she will undergo allergy testing.
Testing for Eosinophilic Esophagitis
The 3 types of food allergy testing for EoE are:
- skin testing
- blood testing
- patch testing
All patients should try to have skin testing and patch testing. In some instances, the Allergist may also recommend blood testing to confirm the results of skin testing. All of these forms of testing may be required to identify all of the possible food allergies in a patient with EoE.
What is patch testing?
Because skin testing and blood testing do not diagnose all of the food allergies a patient with EoE has, we will also place patch testing on your child on Monday. Patch testing is a delayed type of testing and involves putting food in aluminum disks or cups on your child's back with tape and then leaving them there for 2 days.
After 2 days (on Wednesday morning) your child would come back to clinic to have the patches removed from the back. The next day (on Thursday morning) your child would come back one more time to actually have patch test sites read and reviewed.
Once the Allergist figures out all of the food allergies that your child may have, we would discuss how to avoid those foods. Our dietitian is usually involved in the process to make sure your child is still meeting nutritional needs.
After avoiding the foods for at least 3-6 months, the Gastroenterologist may want to repeat the scope to see if the allergy cells have gone away. If they have, your child would return to the Allergist to discuss how to go about reintroducing those particular foods back into the diet.
Some foods may be reintroduced into the diet after a normal biopsy. Usually, one new food is added per week at home while watching your child for any symptoms to come back. We will provide you with a food diary to monitor the symptoms.
One or more endoscopies with biopsy may need to be performed during this process to check for inflammation. The Allergists may want to re-add some foods by first performing a food challenge in the hospital to make sure no serious allergic reactions occur.